BACKGROUND

In South America (SA), rapid population aging underscores the urgent need for effective strategies to detect and manage dementia.

Primary care is a key component of timely detection, yet a regionally harmonized, context- sensitive approach to dementia screening is lacking. This study aimed to develop expert-based recommendations for a brief, feasible, and context-sensitive dementia screening protocol for primary care across SA.

METHODS

• A two-round modified Delphi process was conducted with 20 experts from SA, including neurologists, geriatricians, psychiatrists, and family physicians.

• Round 1, an exploratory phase, used open-ended, ranking, and yes/no questions to gather opinions on cognitive and functional screening tools, cut-off points for subgroups, referral criteria, administration time, professional roles and contextual considerations relevant to low-resource settings.

• Round 2 sought to achieve consensus (≥75%) on items derived from Round 1. Qualitative open-ended responses were analyzed via rapid content analysis to identify themes informing Round 2. Quantitative data were analyzed descriptively.

RESULTS

• A consensus was reached on the timing and target populations for dementia screening.

• Experts also agreed on using an initial screening question to identify potential cognitive decline, the duration of a brief screening battery, and the rolesof health professionals in primary care.

• The cognitive tests considered most relevant for primary care were the MoCA, MMSE, and Clock Drawing Test.

• Experts highlighted the importance of educational, cultural, and sensory adaptations and also recommended strategies for patients without a reliable informant.

• No consensus was reached regarding functional assessment tools or specific cut-off points.

CONCLUSIONS

These guidelines support timely detection, appropriate referral, and integration of dementia screening into broader healthy aging and person- centered care approaches, while highlighting areas requiring further research and standardization across SA.